Palmar erythema is a hereditary or acquired cutaneous finding. This is symmetric and asymptomatic and typically involves thenar and hypothenar eminences. Less frequently, the volar aspects of fingers are also involved.

Erythema palmare hereditarium (hereditary / congenital / familial palmar erythema, red palms, or Lane disease) is a rare, benign, inherited condition. This condition presents at birth and remains stable throughout life. The erythema is unrelated to temperature or exercise. Various modes of transmission, including autosomal dominant and autosomal recessive patterns as well as spontaneous mutations, have been described.

Acquired palmar erythema is associated with various medical or physiological conditions:

• Pregnancy
• Liver cirrhosis (liver palms) – Most common cause of secondary palmar erythema.
• Autoimmune disease such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (reported to be a favorable prognostic sign).
• Endocrine disorders such as hyperthyroidism, especially with thyrotoxicosis, or diabetes mellitus.
• Infections such as Kawasaki disease, gestational syphilis, human immunodeficiency virus (HIV) infection, tuberculosis, human T-cell lymphotropic virus-1-associated myelopathy, brucellosis, and trichinellosis are reported associations.
• Paraneoplastic phenomenon – Known associations include primary brain tumors and brain metastases. Other solid organ malignancies and myeloproliferative disease have been reported as associations.
• Drug-induced palmar erythema – Topiramate and albuterol are implicated.
• Environmental – Smoking (erythema palmare symptomaticum).

Idiopathic palmar erythema is a diagnosis of exclusion.